Kids Health Info

Reduce children's discomfort during tests and procedures

At some point in their lives, many children will need to have
a medical test or a procedure such as a blood test, stitches, an injection, x-ray, or other type of medical imaging.

Here are some tips on how
to help your child feel less scared and stressed. It is
natural for adults to promise children that a test or procedure
will be "pain free" or only "hurt a little." As adults, we
want to protect our children. Children, however, report being told this
not helpful, and it often makes the event scarier.

How do you explain pain to
children and adolescents?

There are different types
of pain messages that our bodies send to our brain. For instance, our brain will send a message to our body if we touch something too
hot or too cold. If we hurt or injure ourselves a pain message is
sent to remind our body to rest and or seek help. It's a natural
process in our bodies.

There are many ways to make
a procedure more comfortable for children and adolescents, for example distraction, relaxation and breathing work very well. These can be
used with pain relieving medicine to reduce pain.

What do I say if my child
asks is it going to hurt?

Always give your child an honest answer. For example, an honest
alternative to saying "this is going to hurt" is to say "some
children say it hurts a bit, others are not so
bothered."

Many parents find it
helpful to understand that children often express or use the word "pain"
to describe fear, distress and anxiety.

Medicines that help reduce
your child's pain

EMLA/AnGel Cream

A cream that numbs the skin and can be very
effective if your child needs an injection or a drip. It needs
to be applied to the skin 45 minutes before the
procedure.

Sucrose

Sweet tasting sugar and water solution is given
to infants under 18 months old to relieve pain and minimise their distress.

Paracetamol or ibuprofen

These medicines are helpful for:

broken bones

plasters

dressing changes

drain insertion and removal

lumbar puncture

stitches

laceration repairs and
immunisations

Or if recommended by your child's GP, surgeon or
nurse.

Sedations

Sedations are medicines that can help reduce
anxiety and fear. Some help reduce pain if it's anticipated during
the procedure. Please discuss these with the staff before your child's appointment.

Before the
procedure

Information about the procedure

Ensure your child is given an explanation
about the procedure from a hospital staff member or
GP. Children report it's important to for them to know:

Why the procedure is needed and how it will
help their body?

How it may happen?

Where it will happen?

What they might feel?

What things make it feel more comfortable? e.g. iPod,
toy or book.

It may help you to re-explain things to your child and answer
any questions.

If your child is under six years of
age, you should explain the procedure just before it
happens.

If your child is over six years of age,
it is best to explain and prepare your child two to
three days before the procedure.

Distraction ideas for infants under six months:

rocking, and stroking their face

gentle patting and having family present

rattles or other baby toys

singing

swaddling - keep baby wrapped up and warm, only exposing areas of body needed for the procedure

sucrose and breastfeeding.

Distraction ideas for toddlers six months to two
years:

sitting up when possible in a hug-like hold

blowing bubbles or a windmill

toys and books that make noise or with
buttons to push

singing your child's favourite song

light-up toys

reading a book.

Distraction ideas for older children:

big belly breathing, blowing away the scary feelings or blowing
away the hurt; breathe in through your nose and
blow out of your toes

blowing bubbles and windmills

counting games

reading a book, especially a noise book, counting or search-and-find
book

playing a favourite DVD, iPad or electronic game

mind pictures, for example think about a favourite sport, family
vacation, school game or activity; let your child tell a story or answer
questions about what is pictured in their mind

ask your child if they want to know what's happening or if they
prefer to focus on an activity instead.

Distraction ideas for adolescents:

listen to music on their phone or an iPod

let them have choices about parental presence and hand holding

mind pictures, for example think about a favourite sport, family
vacation, school game or activity; let your child tell a story or answer
questions about what is pictured in their mind

relaxation and breathing with or with cues

use humour or non procedure talk

play a favourite DVD, iPad or electronic game

Positioning

It's helpful
for children to decide whether they want to lie down or sit for the
procedure, but check with the person doing the test first. Young children may like to sit on your knee, as this
provides security and comfort. Older children may prefer to sit by
themselves and actually watch the procedure as it happens.

During the procedure

Infants, children and adolescents:

Stay with your child. If you think you may not be able to do so, ask
someone your child knows to stay.

Maintain contact with your child during the procedure by
holding their hand or giving them a cuddle or hug.

Remind your child to use the distraction method you have both
decided on:

'Tell me something else about your favourite
place.'

'You are going to find this much easier when you do your
breathing.'

Your words should focus on distracting your child. Many
children find it is not helpful to talk about what is happening,
how the procedure is going or when it will finish.

If your child cries during the procedure let them know that it
is okay to feel upset.

Praise your child for their cooperation.

Tips for parents to remain calm during the procedure

Bring things for you and your child to do while waiting. This
helps manage fear and boredom.

Make sure you understand what will happen before the procedure
starts.

Ask staff about ways to help your child feel more comfortable
and less scared.

Focus on your child and not on how successfully or quickly the
procedure is being done.

After the procedure

Stay with your child until they are calm.

Your baby or infant may like to be cuddled or offered a
feed.

Talk to your child about the things he or she did that were
helpful. Even if your child was upset, find a positive thing to
mention as this can help promote a sense of achievement. For
example: "you did really well with your deep breathing".

Key points to remember

As a parent, you have an important role in helping your child
cope with medical procedures and hospitalisations. You know your
child better than anyone else.

Children generally prefer to have their parent with them during
a procedure.

Answer your child's questions honestly.

Decide with your child which distraction method to use during
the procedure.

Practice some of the distraction methods before the procedure
starts.

Developed by Comfort Kids. First
uploaded January 2007. Updated November 2010.

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Disclaimer This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.